# PRIMECARE FAMILY MEDICAL CENTERS OSCEOLA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1841707171
- **Authorized official:** RENE CASANOVA MD (OWNER/PRESIDENT)
- **Authorized official phone:** (305) 442-1740

## Contact information

- **Practice address:** 217 E OAK ST, KISSIMMEE, FL 34744-4503
- **Practice address phone:** (407) 988-1035
- **Practice address fax:** (407) 988-1034
- **Mailing address:** 7765 NW 48TH ST STE 300, DORAL, FL 33166-5404
- **Mailing address phone:** (305) 442-1740

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ME78770 | FL | Yes |

## Other

- **Enumeration date:** 01/09/2018
- **Last updated:** 01/09/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 264910101 | — | FL |